Objective: To test if otherwise healthy children with tremor have neuropsychological impairment.

Background: Tremor in children has not been as widely studied as tremor in adults, although it is reported that 4.6% of adults diagnosed with ET had onset during childhood (1). Louis et al conducted an assessment of tremor in an on-going prospective cohort study of the effects of pollutants on child development. Tremor was noted in 33.1% in the dominant hand and 12.6% in the non-dominant hand (2). The goal of the present study is to assess the associations between neuropsychological characteristics and tremor in this cohort.

Methods: Tremor was assessed in 317 children who participated in the prospective cohort study. Archimedes Spiral drawings were dichotomously classified into “mild to moderate tremor” versus “all others” (2). The scores were classified into “dominant” and “non-dominant”. Performance on tasks in the neuropsychological domains of Executive, Language, Sensorimotor, Visuospatial, and Memory functions were obtained from this cohort’s NEPSY II scores. The scores of the tasks within each domain were dichotomously classified into the lower quartile of performance versus all others. Logistic regression was performed for each spiral trial and task.

Results: The average age of the subjects was 11 years (SD 1.12). 13.2% had tremor of the dominant hand, trial 1 (DT1) (55% male, 45% female), 9.5% had tremor in the dominant hand, trial 2 (DT2) (66.7% M, 33.3% F), 31.8% had tremor of the non-dominant hand, Trial 1 (NDT1) (50.5% M, 49.5% F), and 21.4% had tremor of the non-dominant hand, trial 2 (NDT2) (57.4% M, 42.6% F). Individuals with tremor in DT1 and NDT2 had higher odds of scoring in the lowest quartile of scaled scores on manual motor sequences, a measure of sensorimotor function (OR 2.55, p = 0.01; OR of 2.07, p = 0.01). Individuals with tremor in DT1 and DT2 had higher odds of poor performance on the Visuomotor Precision, another sensorimotor task (OR = 1.7, p = 0.12; OR = 1.78, p = 0.08). Those with tremor in NDT2 scored in the lower quartile for block design (OR = 2.48, p = 0.03), a measure of visuospatial domain. There was not statistically significant reduced performance in memory and executive function tasks.

Conclusions: Children with tremor have evidence of sensorimotor dysfunction, as measured by NEPSY-II performance. There is no evidence of statistically significant deficits of performance on most memory and executive function tasks.

References: 1. Hornabrook RW, Nagurney JT. Essential tremor in Papua New Guinea. Brain. 1976;99:659–672. 2. Louis ED, Garcia WE, Rauh, VA. Tremor in a Population-Based Cohort of Children in New York City. Pediatr Neurol. 2015 Feb; 52(2): 187-191.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychological-characteristics-of-children-with-tremor/